Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, July 27, 2019

Weekly Overseas Health IT Links – 27th July, 2019.

Here are a few I came across last week.
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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NHSmail registers 11 million blocked attacks in three years

Data released through a Freedom of Information request has revealed that NHS email systems have been subjected to some 11 million attacks over the past three years.
Owen Hughes – July, 16 2019
According to the information released by NHS Digital, the NHSmail system blocked a total of 11.35 million email attacks between its 2016-2019 financial years.
The most common attacks were those categorised as IP or domain reputation attacks, of which 6.12m were recorded.
Anti-spam systems registered 3.62m incidents during this period, while anti-virus systems recorded 852,000 incidents.
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Prescription ordering app Echo snapped up by McKesson UK

NHS prescription reminder and tracking app, Echo, has been acquired by the owner of LloydsPharmacy for an undisclosed sum.
Owen Hughes – 16 July, 2019
The app, which allows patients to order repeat medication from their GP, has been scooped up by healthcare organisation McKesson.
McKesson said the purchase reflected part of the organisation’s new digital healthcare strategy toward providing simpler and more convenient ways for customers to manage their health digitally.
Catherine McDermott, the company’s chief digital officer, said: “We know that our customers are always looking for ways to make their lives easier by managing more things online. That’s why growing our digital capabilities is one of our top priorities. Our goal is to develop innovative technologies that enable us to better serve our customers and patients by providing them with added choice and convenience.
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Do Elon Musk’s brain-decoding implants have potential? Experts say they just might

July 18, 2019
SAN FRANCISCO — Okay, the “sewing machine” is pretty cool. But if the device that Elon Musk’s neurotechnology startup Neuralink developed to implant thousands of electrodes into brains (of rats and monkeys so far, and humans eventually) were its only accomplishment, Tuesday night’s big reveal would have been a big meh. Instead, six independent experts in the kind of brain-computer interfaces that Neuralink is developing told STAT they are impressed for the most part, though caveats abound.
“Overall, the concept is impressive and so is the progress they’ve made,” said neurobiologist Andrew Schwartz of the University of Pittsburgh Medical Center, a pioneer in the technology. “But a lot of this still seems to be conceptual. It’s hard to tell what’s aspirational and what they’ve actually done.”
The immediate aim of the San Francisco startup is a system enabling people who are paralyzed to use their thoughts to operate computers and smartphones. That has been done before, including by Schwartz’s group and one at Brown University, where in 2011 two tetraplegic patients who had been implanted with the “BrainGate” neural interface system were able to control robotic arms with their thoughts, including lifting a bottle of coffee and drinking it.
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Stewart: The EPIC hospital-records system is like a tour of the Irish countryside

In pre-GPS days, there appeared to a visitor to be no correlation between the road signs, the maps, and what the roads actually did in Ireland. To the uninitiated, The Ottawa Hospital's new record system seems similar – but without the pubs.
Updated: July 16, 2019
Learning The Ottawa Hospital’s new patient care software program, EPIC, has brought back pleasant memories of renting a car to explore the pre-GPS 1990s’ Irish countryside. The challenge in Ireland was that there appeared to be no correlation between the road signs, the maps, and what the roads actually did. A road sign (typically very small and placed just after the intersection rather than before it) would point the way to a small hamlet a few kilometres up the road. However, the hamlet would be too small to be shown on the map, and the large city a few kilometres beyond the hamlet would not be listed on the road sign.
When I would invariably get lost, the very hospitable Irish would gladly offer directions, and without exception it would be along the lines of “You go past the first two pubs on the right, then three pubs on the left, then two more pubs on the right, and then you turn right at the next pub on the left after that. You will then drive until you see a pub called The Crown and Anchor, and the town you are looking for is right beside that pub.” Also, without exception, they would then add “And you can’t miss it!” Except by the time I got on the road again, I could no longer remember whether I was supposed to make a right turn at the ninth pub on the left or a left turn at the 10th pub on the right.
When I would then ask the next person I saw, they would exclaim, “Oh no, a much better way is to go down this other road past the first five pubs on the left, then the next on the right then two more on the left, and turn left at the next pub after that on the right. And you can’t miss it!”
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Assessing the safety of electronic health records: a national longitudinal study of medication-related decision support

  1. A Jay Holmgren1,2,
  2. Zoe Co2,
  3. Lisa Newmark2,
  4. Melissa Danforth3,
  5. David Classen4,
  6. David Bates2

Author affiliations

Abstract

Background Electronic health records (EHR) can improve safety via computerised physician order entry with clinical decision support, designed in part to alert providers and prevent potential adverse drug events at entry and before they reach the patient. However, early evidence suggested performance at preventing adverse drug events was mixed.
Methods We used data from a national, longitudinal sample of 1527 hospitals in the USA from 2009 to 2016 who took a safety performance assessment test using simulated medication orders to test how well their EHR prevented medication errors with potential for patient harm. We calculated the descriptive statistics on performance on the assessment over time, by years of hospital experience with the test and across hospital characteristics. Finally, we used ordinary least squares regression to identify hospital characteristics associated with higher test performance.
Results The average hospital EHR system correctly prevented only 54.0% of potential adverse drug events tested on the 44-order safety performance assessment in 2009; this rose to 61.6% in 2016. Hospitals that took the assessment multiple times performed better in subsequent years than those taking the test the first time, from 55.2% in the first year of test experience to 70.3% in the eighth, suggesting efforts to participate in voluntary self-assessment and improvement may be helpful in improving medication safety performance.
Conclusion Hospital medication order safety performance has improved over time but is far from perfect. The specifics of EHR medication safety implementation and improvement play a key role in realising the benefits of computerising prescribing, as organisations have substantial latitude in terms of what they implement. Intentional quality improvement efforts appear to be a critical part of high safety performance and may indicate the importance of a culture of safety.
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A.I. has a bias problem and that can be a big challenge in cybersecurity

Published Wed, Jul 17 2019 1:21 AM EDT Updated Thu, Jul 18 2019 12:50 AM EDT
Saheli Roy Choudhury and Blanche Lim





Key Points
  • Inherently biased artificial intelligence programs can pose serious problems for cybersecurity at a time when hackers are becoming more sophisticated in their attacks, experts told CNBC.
  • Bias can occur in three areas — the program, the data and the people who design those AI systems, according to Aarti Borkar, a vice president at IBM Security.
  • The role of AI is expanding in cybersecurity. Many CEOs see cyber attacks as the biggest threat to the global economy over the next decade.
Inherently biased artificial intelligence programs can pose serious problems for cybersecurity at a time when hackers are becoming more sophisticated in their attacks, experts told CNBC.
Bias can occur in three areas — the program, the data and the people who design those AI systems, according to Aarti Borkar, a vice president at IBM Security.
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Providers Must Go Beyond Frameworks for Strong Risk Management

Recent reports have shown many healthcare providers don’t conform with HIPAA or adhere to a specific security framework like NIST: It’s critical these organizations better develop risk management programs to shore up these major security gaps.
July 17, 2019 - On a near-daily basis, there are reports of yet another healthcare provider falling victim to a breach or security incident. Whether due to outdated systems, a lack of resources, human error, or other contributing factors, healthcare isn’t doing enough to shake off the target hackers have placed on its back.
In fact, a recent report from CHIME and KLAS showed the severity of the divide between the security programs of larger healthcare organizations that typically have stronger cybersecurity budgets and their smaller counterparts that are struggling to keep pace.
Small providers are less likely to adhere to cybersecurity programs, such as hiring a chief information security officer. Others lack bring-your-own-device management, or fail to conduct annual enterprise-wide exercises to test those plans. The same report showed small providers are failing to leverage risk management.
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US below global average in health tech adoption, survey finds: 3 notes

Andrea Park – 18 July, 2019
Though American healthcare providers have embraced the use of EHRs at record-high rates, they lag behind the rest of the world in adopting other digital health technologies such as telehealth and artificial intelligence.
Additionally, according to Philips' Future Health Index 2019 report, though U.S. clinicians rely more on EHRs to share patient information than those in many other countries, they are much less satisfied with the effects of that reliance.
Here are three key takeaways from the report, which surveyed more than 3,100 healthcare professionals in 15 countries.
1. Of the U.S. providers surveyed, 84 percent use EHRs in their practice, considerably higher than the 15-country average of 76 percent.
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By HIT Think Why rising ransomware risk requires commitment to best practices

  • July 19 2019, 5:52pm EDT
Last week, the United States Conference of Mayors adopted a resolution against paying ransoms. What’s interesting about this is it’s creating what is essentially a vertical front of communities against ransomware. It may well disincentivize attackers from targeting towns and cities.
I’m hopeful and encouraged by this action, but I worry that this resolution is a dismissal of culpability and should have been about investing in cybersecurity before a ransomware outbreak, instead of advertising that we’d rather jump on a sword than pay a ransom.
I’ve been writing about the need for ransomware victims to prioritize their self-interest and consider paying ransom if they can establish that the actor will credibly provide decryption keys and that recovery would be discernably less costly in doing so. One of the common responses I’ve received in this regard is that I’m encouraging the creation of a ransomware market because the act of paying ransoms encourages more actors to get involved in this space—supply and demand.
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Telehealth services expand at state level, but adoption barriers remain

American Telemedicine Association's "State of the States Report" finds progress, but still sees strategies for states to be incentivized to adopt pro-telehealth policies.
July 19, 2019 11:03 AM
Expansion of telehealth coverage and reimbursement at the state level has grown since 2017, according to the latest American Telemedicine Association
The report indicates that while states are realizing the many benefits of telehealth and are implementing policies that advance utilization, some states still lack the authority or resources needed to fully deploy telehealth across the state.
"There has been a lot of progress at the state and Federal level, and there's huge opportunity to accelerate increased adoption with supportive legislation at both the state and Federal level," Ann Mond Johnson, CEO of the ATA, told HealthcareITNews. "The progress at the Federal level helps drive state action."
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MIPS Audits: Lessons Learned from Meaningful Use

July 17, 2019
The following is a guest blog post by Jim Tate, Founder of EMR Advocate & MIPS Consulting.
Just as the Meaningful Use (MU) EHR Incentive program brought potential audits to providers, so it will be with the MIPS program. Both programs were enacted by Federal legislation, and while there are differences, they are also similarities.
The MU program contained EHR incentives for both Medicare and Medicaid defined providers. For Medicare eligible providers (EP) there was a sole CMS contractor responsible for all audits and appeals. The Medicaid audits and appeals were handled at the state level by a number of different entities. If an EP failed an audit, and it was truly a pass/fail system, the received incentive was recouped for the year under audit. Audits were conducted only against a specific EP for a specific year. The funds recouped involved no penalties, only the received incentive amount. I estimate that perhaps one-third of MU audits were failed and according to CMS the number one cause of a failed audit was the lack of an acceptable Security Risk Analysis.
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How Data Analytics Has Curbed the Prescription of Opioids in Philly

A new partnership between Jefferson Health and local software company Qlik may be one big step in reducing patients’ exposure to prescription painkillers.
By Queen Muse· 7/17/2019, 9:33 a.m.
Though the opioid epidemic is not nearly as bad as it was in 2017 when the misuse of prescription painkillers resulted in more than 5,000 overdose deaths in Pennsylvania, it is still impacting many lives. In Philadelphia alone, more than 1,100 people died from opioid-related overdoses in 2018, down from more than 1,200 in 2017.
The slight decrease in overdose deaths can be partly attributed to changes in prescription guidelines aimed at limiting dosage and trimming the number of circumstances in which opioids could be prescribed. Following recommendations from Mayor Kenney’s Task Force to Combat the Opioid Epidemic in Philadelphia, health care providers across the city have updated care policies to ensure physicians prescribe highly addictive medications more judiciously.
As the second largest employer in Philadelphia, Jefferson Health has decided to go a step further by forming a partnership with Philadelphia-based business intelligence software company Qlik.
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70% of healthcare organizations have experienced a data breach

Mackenzie Garrity – 18 July, 2019
Of the 70 percent of healthcare organizations that have experienced a data breach, one-third reported a security incident in the last year, according to the 2019 Thales Data Threat Report — Healthcare Edition.
Here are five key takeaways:
1. While all healthcare organizations reported that they are collecting, storing and sharing sensitive data, only 38 percent said they are encrypting the data.
2. A majority of organizations (80 percent) are transferring sensitive data to the cloud.
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AAFP supports team care model that frees up physicians from EHR documentation

Jackie Drees – 18 July, 2019
Physicians who received in-room support for EHR documentation reported greater satisfaction, according to research recently published in the Annals of Family Medicine and supported by the American Academy of Family Physicians.
The model consists of at least two or three care team coordinators, who are nurses or medical assistants, which help relieve each physician of his or her administrative responsibilities in order to focus on the patient. The team coordinator may begin the patient visit by completing tasks such as taking the individual's history, ensuring his or her medications are accurate and planning the appointment agenda based on the patient's concerns.
After the initial administrative tasks are completed, the physician joins the appointment and talks with the patient, face-to-face, without needing to input any data into the EHR. The physician then performs a physical exam and discusses a diagnosis and care plan with the patient while the team coordinator, who is still in the room, records notes EHR documentation. Once the physician exits, the team coordinator remains with the patient to "review the care plan; set up referrals, labs and follow-up visits; and provide health coaching as indicated," according to the report.
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HHS manages risk in using cloud through federal program

Published July 18 2019, 2:24am EDT
The Department of Health and Human Services has embraced a government-wide program that provides a standardized approach to the cloud through security assessment, authorization and continuous monitoring.
HHS Chief Information Officer Jose Arrieta told a House subcommittee on Wednesday that the agency sees the Federal Risk and Authorization Management Program (FedRAMP) as a “strategic enabler” and the “fulcrum” for its IT modernization efforts, noting that more than 60 FedRAMP-certified cloud technologies and services are in use across the department.
According to Arrieta, leveraging cloud technology through the FedRAMP process has resulted in greater data sharing, enhanced data security and financial savings. He said HHS was the first agency in 2013 to sponsor a cloud service provider through FedRAMP and in the past five years has authorized 14 cloud service providers and currently maintains authorizations for nine unique cloud offerings.
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How a layered data security strategy helps providers stay safer

Published July 18 2019, 5:38pm EDT
The recent data breach at the Los Angeles County Department of Health Services demonstrates the risk that hired third-party vendors pose to healthcare organizations.
The phishing attack at the Los Angeles agency compromised the health information of 14,600 persons.
While many providers continue to leave themselves open to attack by not using appropriate security controls, the controls are comprised if appropriate policies are not in place, says Andrea Limbago, chief social scientist at Virtru, a data encryption vendor. “End-to-end encryption would have made the attack more difficult to pull off, and therefore may have deterred the attacker,” Limbago explains.
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The National Digital Health Blueprint report to ensure “Health for all”

By New Delhi Times Bureau on July 18, 2019
The National Digital Health Blueprint (NDHB) report was released in the public domain by the Union Minister of Health and Family Welfare, Dr. Harsh Vardhan on 16th July.
The occasion was graced by several eminent presences including Shri Ashwini Kumar Choubey, Minister of State for Health and Family Welfare, Smt Preeti Sudan, Secretary (HFW) and Shri. J. Satyanarayana, Chairman of Committee on NDHB.
NDBH aims to create a National Digital Health Eco-system that supports Universal Health Coverage in an effective, inclusive, affordable, accessible, timely and safe manner. It will be attained by relying on the provision of a wide range of data, information, and infrastructure services, duly leveraging open, interoperable, standards-based digital systems, and ensuring the security, confidentiality, and privacy of health-related personal information.
The move is in lieu with Prime Minister, Mr. Narendra Modi’s commitment of ensuring accessible and high-quality healthcare to all through Digital India Programme. Dr. Harsh Vardhan said, “The digital health interventions are accelerating this transformation and have a huge potential for supporting Universal Health Coverage (UHC). India has everything that can help it achieve Health for all.”
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Digital health funding in first half of 2019 hits record $5.1B: report

Jul 16, 2019 12:31pm
Global venture capital funding for digital health companies in the first half of 2019 hit $5.1 billion with 318 deals, the highest amount raised in the first six months of a year so far, according to a new report.
In the second quarter of 2019, venture capital funding held strong at $3.1 billion in 169 deals following the $2 billion raised in 149 deals in the first quarter, according to a new report from  Austin, Texas-based communications and research firm.
In the first half of 2018, digital health companies raised $4.9 billion in 383 deals.
Global digital health firms have received over $40 billion in venture capital funding deals since 2010, with U.S. companies raising approximately $30 billion to date, Mercom Capital Group reported.
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Clinical Pathology Laboratories the latest company impacted by massive AMCA breach

Jul 17, 2019 10:31am
Clinical Pathology Laboratories says 2.2 million patients may have had their personal information impacted by a security breach that occurred at the American Medical Collection Agency.
A fourth clinical lab impacted by a security breach at a third-party billing collections firm has come forward.
Clinical Pathology Laboratories, based in Austin, Texas, says 2.2 million patients may have had their names, addresses, phone numbers, dates of birth, dates of service, balance information and treatment provider information impacted by a security breach that occurred at the American Medical Collection Agency.
The victims of the massive AMCA breach include Quest Diagnostics, LabCorp and Opko Health, under one of its subsidiaries, BioReference Laboratories, Inc. With the inclusion of Clinical Pathology Laboratories' patients, the total number of patients' data potentially exposed by the breach is now over 22 million.
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Ransomware Costs on the Rise, Causes Nearly 10 Days of Downtime

Coveware’s analysis of ransomware attacks from the second quarter of 2019 shows the malware causes an average of 9.6 days of downtime, with organizations losing about 8 percent of data.

July 16, 2019 - The cost of ransomware attacks across all sectors exponentially increased during the second quarter of 2019, with ransom payments rising 184 percent to $36,295 from $12,762 during the second quarter, according to a Coveware analysis.
Coveware’s Q2 Ransomware Marketplace report analyzed anonymized ransomware data handled by the security firm’s incident response team and other incident response firms that rely on Coveware’s incident response platform. In total, healthcare made up 13.6 percent of Q2 ransomware incidents.
The researchers found the average downtime also increased from 7.3 days during the first quarter, to 9.6 days, which was primarily driven by the increase in incidents caused by the ransomware variant Sodinokibi cases targeting IT managed service providers and their clients.
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Providers not using encryption enough for data in the cloud

Published July 17 2019, 5:15pm EDT
A recent survey suggest that a majority of healthcare organizations are now putting data in the cloud, often without sufficient security protection.
The survey found that 80 percent of 100 healthcare organizations are placing sensitive data in the cloud. Some 70 percent of respondents reported that they have experienced data breaches—the highest rate of any industry in the survey—and 25 percent failed data security compliance audits in the past year.
The 2019 Data Threat Report from Thales, which offers information technologies and advisory services, provides clear evidence that patient information is at risk in the face of rapid cloud adoption, with inadequate encryption rates in the healthcare industry, says Tina Stewart, the company’s vice president of market strategy for cloud protection and licensing.
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HIT Think How 5G could bring multiple benefits to healthcare

Published July 17 2019, 6:13pm EDT
The more bandwidth-intensive connected medical devices and mobile devices hospitals deploy, the more it strains our health IT infrastructures.
Something has to give. Many communications leaders see 5G technology’s real-time high bandwidth and lower latency access as powerful new technology features that are needed to expand healthcare applications’ capabilities and the functioning of medical devices, robotics and mobile devices.
Some say 5G will be transformative. Others say it won’t be sufficiently transportable geographically to achieve the high goals promised by carrier companies. And rumbling in the background are the outlier worries that 5G itself could be a health risk that matters more than technology advances.
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Resident Guide app piloted at NZ’s Wellington Hospital

The cloud-based Resident Guide app provides access to a combination of local operational and clinical guidelines.
July 17, 2019 02:53 AM
Capital and Coast District Health Board (DHB) in New Zealand is piloting the Resident Guide app for onboarding junior doctors.
The six-month pilot begins in mid-August and involves all resident medical officers (RMOs) at Wellington Hospital.
Junior doctors are rotated around hospitals four times a year and need to quickly upskill on the way things are done at each new location, such as how to book tests and consults with other specialties.
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2019

Age, race disparities found in the use of hospital patient portals

Patients age 60 and over used the portal less than younger patients, and African Americans used the portal less than white patients.

Jeff Lagasse, Associate Editor
Removing the barriers of access to technology does not close the digital divide for African American and older patients, according to new research from The Ohio State University College of Medicine.
As part of a larger examination of patient portal use, researchers looked at the use of patient portals while people are admitted in the hospital. Over a one-year period, they found patients age 60 and over used the portal less than patients ages 18 to 29, and African American patients used the portal less than white patients.
WHAT'S THE IMPACT
Patient portals, and other types of patient-facing technology, are meant to engage patients more in their healthcare by facilitating better communication with the care team. They allow patients to access things like test results, progress notes and other information that's stored in their medical records.
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Intermountain launches new spinoff with focus on value-based care

Castell will offer technologies and services to guide care decisions, manage patient experience, implement virtual care, address social determinants and more, building from the health system's own best practices.
July 17, 2019 12:45 PM
Intermountain Healthcare has launched a new healthcare company with the aim of helping providers, payers, accountable care organizations and others manage the challenges of value-based reimbursement.
WHY IT MATTERS
The new company, named Castell, seeks to help these organizations speed their transition from volume to value-based care, with analytics, decision support and other innovative tools hatched at Intermountain.
Rajesh Shrestha, who also serves as chief operating officer of Community Based Care for Intermountain, has been named president and CEO of Castell.
The company aims to make some of the tools and best practices developed at the Salt Lake City-based health system available to other healthcare organizations seeking to improve their ability to offer value-based care.
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Centre Releases New 'Blueprint' to Access Health Data 'Within Five Clicks'

The framework says Aadhaar will be a key document used to identify people.
16 July, 2019
New Delhi: For years, India’s health ministry has been trying to work out how they plan on incorporating technology into healthcare. The lowest hanging fruit has not been to increase access to healthcare via technology, but to collect massive amounts of health data and figure out how to use technology to harvest it.
One move in this direction is the government’s latest ‘National Digital Health Blueprint’ (NDHB) which is now open for feedback from stakeholders for a period of three weeks.
The government plans on using Aadhaar as a primary identifier here, and wants a citizen to be able to access their data “preferably within 5 clicks.”
One of the major triggers for this blueprint is the Ayushmaan Bharat health insurance scheme, which routinely generates “enormous amounts of health data” on Indian patients. Over 30 lakh patients have reportedly used the scheme so far, but the government has been reluctant to release any disaggregated anonymised data. The health minister said on Monday that the NDHB will “accelerate our efforts towards universal health coverage,” or the health insurance model.
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New ML tool helps gauge severity of pediatric head injuries

Published July 16 2019, 4:25pm EDT
A new machine learning model is better at flagging which children can avoid CT scanning after a head injury than currently used tools.
CT scanning is the standard for the fast diagnosis of traumatic brain injury (TBI). However, it’s expensive and exposes patients to a greater risk of developing cancer.
The current clinical decision support tool used to determine whether a child who suffers a head trauma needs a CT scan is the Pediatric Emergency Care Applied Research Network (PECARN) rule, which uses predictors such as altered mental status and signs of fracture. Children with very low risk of clinically important TBI (ciTBI) don’t need a CT scan—those in the high-risk category always receive a CT scan. Children in the moderate risk category may receive a CT scan, depending on additional factors.
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HIT Think How to assess the role of governance in data lakes and warehouses

Published July 16 2019, 5:04pm EDT
Data lakes and data warehouses are both used to store data. And while they have innate differences and serve organizations differently, data governance is a universal thread that runs through both—and it without which, they would be rendered useless.
Data lakes are repositories that can be structured or unstructured and can contain traditional transaction-type data, phone logs or any other form of information. They are truly a repository of all types of organizational data.
With data lakes, data can be brought in quickly, without complex provisioning, and there is no time spent on how it relates or should interact with other data sitting in the lake. It should be kept as close to its raw form as possible so that it can be used in multiple functions and isn’t locked into a particular use. Because all data is available, it enables much deeper forms of analytics.
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Survey shows progress in digitising nursing care

Nursing services and facilities in Germany are increasingly working digitally, and private providers in particular are well positioned.
July 16, 2019 09:41 AM
The bpa has now published a press release looking at which areas of work in German nursing care are particularly well digitised.
WHAT HAPPENED
According to the bpa study, 89% of inpatient and outpatient nursing care companies already rely on digital processes for documentation or billing, and 71% of those surveyed stated that their employees communicate digitally with each other.
With 75%, three out of four nursing services now also provide a digital communication channel to doctors and pharmacies. In addition, 88% of the participating companies use digital tools for duty and route planning and a further 77% for quality control.
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For value-based care, a Texas health system puts cost and risk data at the point of care

With the cost data technology integrated with its Epic EHR, Houston Methodist Sugar Land has reported approximately $717,000 in attributable cost savings with an average incremental cost reduction of $105 per admission.
July 16, 2019 12:57 PM
As a health system, Houston Methodist Sugar Land has multiple charges. It’s called to enhance the patient experience, increase delivery of personalized care, improve clinician efficiency and productivity, all while being cost-conscious stewards of resources.
THE PROBLEM
The shift from volume- to value-based care and payment models requires physicians to focus on exceptional care delivery while also managing resources appropriately. Physicians always focus on quality of care. But now, they also are being called upon to partner to reduce overall costs of care.
“Ultimately, however, we can’t partner to manage costs if we don’t have the data we need to aid in cost-conscious, clinical decision making,” said Dr. Nicholas Desai, system chief medical information officer and podiatric surgeon at Houston Methodist Sugar Land. “A 2018 Deloitte survey of 624 U.S. primary care and specialty physicians revealed that 72% of those surveyed consider cost data valuable, especially at the point of care, while only 28% receive this information.”
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How Finland is teaming up with pharma to identify genetic variants in disease

The country's FinnGen Project seeks to use its unique population bottleneck and cohesive health records to drive genetic insights.
July 12, 2019
Deep in the belly of the University of Helsinki, large metallic cylinders line a basement lab. While the setting is clinical, scientists have added a playful touch with snow-themed name tags on each of the vats. Still, the mission of the lab is serious — inside “snow queen” and “snow castle” lie genetic samples that could potentially help decode genetic variants responsible for disease.
Finland is unique 
Finland came onto the world stage last year when it was named “happiest country” by Forbes. But it isn’t just their happiness scores that make the Finnish people unique. 
Situated in the far northeast corner of Europe, over the last few millennia Finland has seen less immigration than other parts of Europe. This has led to Finland becoming one of the largest population bottlenecks, meaning that the Finnish gene pool is largely homogeneous. 
This fact can help scientists pinpoint gene variants that are linked to specific diseases, Anu Jalanko, project manager at FinnGen, said at a media event in June. Instead of researchers sifting through billions of variants to link them to a disease or condition, they need only sift through hundreds of thousands.
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Peddlers Of Medical Misinformation Are Using Social Media 'Censorship' As A Selling Point

Jul 15, 2019, 8:00pm
No one has ever accused Mike Adams, the self-proclaimed Health Ranger, of being an understated guy, but recent events have taken him to new, shouty heights. After Adams’ website, Natural News, had its page suspended by Facebook in June for violating the company’s spam policies, Adams likened the suspension to genocide and said U.S. President Trump should use the military, if necessary, to break up tech companies. But Adams and other peddlers of medical misinformation, including many anti-vaccine personalities, are also working hard to make their supposed muzzling by social media companies into a selling point and a profit-driver.
In an email blast on June 30, Adams accused Google of gaming search results to “to defame and attack all natural health topics, all while banning natural health websites from its search results.” He added that the search engine giant “has gone all-in with Monsanto, Big Pharma, chemotherapy, pesticides, 5G, geoengineering, fluoride and every other poison you can imagine.”
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Jul 11, 2019, 11:55pm

The Five Components Of Autonomous Leadership

Barry Libert and Megan Beck are co-founders at AIMatters, an AI startup.
It was only four years ago that AlphaGo began beating the world’s top professional Go players and Google released TensorFlow, an open-source software library for machine learning applications such as neural networks.
Since then, along with the expansion of IBM’s Watson, Amazon’s Alexa and Microsoft’s Cortana, the buzz associated with artificial intelligence (AI) has grown steadily as leaders around the world begin to examination how automation can help their organizations and customers. However, recent research from PWC shows that despite the fact that leaders perceive that AI is important—more important than the advent of the Internet—very few are actively investing in this new technology. 
This is a problem. AI and automation are simply the latest in a long line of technological innovation—and will soon become essential in every part of the organization. Automation, for example, will not be contained to manufacturing plants and their shop floors. Automation is already affecting marketing, operations, human resources, and it will soon assist the strategy decisions that happen at the executive team and board level.  After all, why should anyone believe that the same principles that allow robots to enable marketers cannot simultaneously enable business executives.
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Jul 14, 2019, 02:40pm

Why AI Is The Future Of Cybersecurity

Louis Columbus
These and many other insights are from Capgemini’s Reinventing Cybersecurity with Artificial Intelligence Report published this week. You can download the report here (28 pp., PDF, free, no opt-in). Capgemini Research Institute surveyed 850 senior executives from seven industries, including consumer products, retail, banking, insurance, automotive, utilities, and telecom. 20% of the executive respondents are CIOs, and 10% are CISOs. Enterprises headquartered in France, Germany, the UK, the US, Australia, the Netherlands, India, Italy, Spain, and Sweden are included in the report. Please see page 21 of the report for a description of the methodology.
Capgemini found that as digital businesses grow, their risk of cyberattacks exponentially increases. 21% said their organization experienced a cybersecurity breach leading to unauthorized access in 2018. Enterprises are paying a heavy price for cybersecurity breaches: 20% report losses of more than $50 million. Centrify’s most recent survey, Privileged Access Management in the Modern Threatscape, found that 74% of all breaches involved access to a privileged account. Privileged access credentials are hackers’ most popular technique for initiating a breach to exfiltrate valuable data from enterprise systems and sell it on the Dark Web.
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Surescripts files motion to dismiss FTC's antitrust case

Jul 15, 2019 1:46pm
Electronic prescribing company Surescripts has fired back at the Federal Trade Commission in its antitrust case and filed a motion to dismiss the FTC's charges in federal court on Friday.
The FTC filed a lawsuit against Surescripts in federal court on April 17, accusing the health information company with illegally monopolizing the e-prescribing market. It's the FTC's latest move to rein in what it views as anti-competitive tactics in the healthcare industry.
The FTC complaint focused on certain provisions of Surescripts' electronic prescribing and eligibility contracts that it alleges are anti-competitive. The company employed "illegal vertical and horizontal restraints in order to maintain its monopolies over two e-prescribing markets: routing and eligibility," according to the FTC's allegations.
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An insurer built an algorithm to help employers track opioid use. Now they're giving away the data for free.

Jul 15, 2019 1:55pm
Washington-based benefits company First Choice Health is aiming to make opioid use data available to employers—even those that don’t contract with it for health coverage. 
FCH, a provider-operated health benefits company, built an algorithm to comb employer’s claims data to measure opioid use among employees across several metrics. That data is then converted into a report they can use to identify issues with abuse. 
The reports are Health Insurance Portability and Accountability Act compliant and are thus stripped of personal data for individual workers. However, it can be used to identify high rates of opioid use among the workforce, information that can then be adapted into initiatives to mitigate the problem, John Robinson, M.D., chief medical officer at FCH, told FierceHealthcare. 
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Opinion: The democratisation of information

Charles Alessi, HIMSS chief clinical officer, looks at the impact of patients becoming more informed, assertive and engaged in their care.
July 15, 2019 09:56 AM
The main driver is the democratisation of information. While information and knowledge were once only the territory of the physician, now everyone is able to access the raw information through digital technologies. This does not necessarily translate into personalized evidentially based insights however and physicians are having to spend time with patients assisting and guiding them to make sense out of large amounts of information available. This process necessitates a change in the interaction between physician and patient. Not only is it very different from the often, didactic exchanges in the past where information was imparted, and a few questions answered, but the requirement to assist the patient assess the information they already have gleaned as well as inform them of what is missing and personalize it, is inevitably putting more pressure on physicians in an already crowded consultation.
Patients today can also wholly appropriately be more conscious that care plans need to be personalized to their needs and aspirations. The days of evidence based care which is similar for everyone is gone and the days of evidence based care for one are here. Is this a bad thing? I think not. The more care and treatment plans are personalised, the more they are owned by patients. The more we manage to activate patients to take responsibility for their own health and care, the more traction we get with actually living treatment plans rather than being aspirations which are never wholly achieved.
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Replacing an EHR comes with many challenges and costs

Published July 15 2019, 1:50am EDT
The vast majority of healthcare provider organizations use electronic health records and physician practice management systems to manage the care they give to patients.
Over time, functionality in the EHR and PPM systems can’t keep up with emerging demands, often compelling an organization to initiate a search for new systems. Often idyllically viewed as an easy answer to emerging challenges, switching systems often offers a gauntlet of challenges.
As healthcare organizations rethink their original—or even second or third—system choices, they often take on new—and sometimes, unexpected—problems and costs.
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Tech proves accurate in identifying patients with irregular heartbeat

Published July 15 2019, 1:40am EDT
A new method for evaluating electrocardiographic signals has been shown to be more effective than cardiac telemetry in detecting atrial fibrillation in stroke patients.
The approach—called electrocardiomatrix—converts two-dimensional signals from the ECG into a three-dimensional matrix that enables fast, accurate and intuitive detection of cardiac arrhythmias, according to researchers at Michigan Medicine.
“We validated the use of our technology in a clinical setting, finding the electrocardiomatrix was an accurate method to determine whether a stroke survivor had an Afib,” says co-inventor Jimo Borjigin, an associate professor of neurology and molecular and integrative physiology at Michigan Medicine.
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New app aims to make it easier to assess device safety

Published July 15 2019, 5:06pm EDT
Software vendor Soom Safety has built a free mobile app that enables healthcare providers and patients to ensure the safe use of a medical device.
The app enables users to receive instructions for directions on how to use, as well as safety and recall information directly from the device manufacturer and the Food and Drug Administration.
“We built Soom Safety to help patients and caregivers relying on implanted medical devices and using medical devices at home answer one critical question,” says Charlie Kim, the company’s president and CEO. “Is this medical device safe to use?”
The app is intended to prove it can access safety and use information from scanning a medical device barcode, thanks to a FDA decision in the early 2000s to enable the use of application programming interfaces to make it easier for healthcare stakeholders to find industry information.
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How To Get A Cheaper Prescription Before Leaving The Doctor’s Office

Phil GalewitzJuly 10, 2019
When Mary Kay Gilbert saw her doctor in May for a skin infection on her leg, she wasn’t surprised to receive a prescription for an antibiotic cream.
But Gilbert, 54, a nurse and health consultant, was shocked when her physician clicked on the desktop computer and told Gilbert the medicine would cost $30 on her Blue Cross and Blue Shield plan.
“I was like, ‘Wow — that’s pretty cool that you know that information,’” she recalled telling the doctor in Edina, Minn.
Allina Health, a large Minnesota hospital network to which Gilbert’s doctor belongs, is one of a growing number of health systems and insurers providing real-time drug pricing information to physicians so they can help patients avoid “sticker shock” at the pharmacy.
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Weekly News Recap

  • Corepoint Health and Rhapsody merge.
  • Waystar acquires Digitize.AI.
  • OmniSys acquires Strand Clinical Technologies.
  • Provident St. Joseph Health and Microsoft announce plans to turn a Seattle-area hospital into a Microsoft-powered “hospital of the future.”
  • IBM closes its $34 billion acquisition of Red Hat.
  • ONC announces that Executive Director Steve Posnack, MS, MHS will become deputy national coordinator when Jon White, MD steps down in mid-August.
  • Providence St. Joseph Health says it plans to create a billion-dollar business from its Engage, Bluetree, Epic Community Connect, and other non-clinical projects, also noting that it will replace Meditech in its acquired hospitals that are using it.
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Health IT Workarounds – Funny or Insanity?

July 12, 2019
Healthcare is full of workarounds. Many of them show an extreme amount of creativity. It’s just unfortunate that all of those creative juices are spent on workarounds and not the core problems. While many of the health IT workarounds out there are about health IT people doing what they need to in order to get stuff done, there has to be a better way.
A little while back, Janae Sharp asked for people to share examples when health IT was used as a workaround rather than solving the root workflow or data entry problem. The answers she got were insightful (and it seems a little cathartic for some). Here are a few that stood out to me.
Yep. Aaron is spot on. This was my response.
Aaron Mier, CIO for UT Austin’s Dell Medical School, then went on a tear of them (consolidated here for easy reading):
Exhibit 2: When a Med device vendor tells you that you cannot encrypt their system because of “ FDA certification “ and therefore you complete a risk assessment stating that, literally attach a chain with a lock to the device, and put a camera on it with real time surveillance.
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Enjoy!
David.

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